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AmeriHealth Insurance Coverage for Drug and Alcohol Rehab

Written by: Goeffrey Andaria, Mental Health Writer

Reviewed by: Dr. Carl Williams, Ph.D., LCADC

Treatment for mental health disorders and drug addiction problems is an essential health benefit under the Affordable Care Act (ACA). All insurance providers should offer coverage for mental health and drug and alcohol rehab costs. AmeriHealth will cover at least part of your mental health disorders if you have such health care coverage.

AmeriHealth's customers get varied coverage levels based on how well they meet specific requirements. For example, the proportion of your treatment expenses covered by insurance will vary depending on the rehabilitation program you pick, where you live, and the AmeriHealth plan you choose. If you have AmeriHealth insurance and need medical care, you should visit a facility that is part of the network for your particular plan.

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Co-Insurance

Deductibles

Co-Payment

Typically, co-insurance percentage range from 20% to 40%, and the insurance company clears the rest.

The amount you pay out-of-pocket for treatment before the health plan starts helping with payments.

Co-pay is a fixed amount you must clear (usually when you receive treatment) for covered treatment services.

What is AmeriHealth?

What kind of medical services does AmeriHealth cover?

AmeriHealth out-of-pocket costs

How long does AmeriHealth cover drug and alcohol addiction treatments?

AmeriHealth out-of-network vs. in-network alcohol and drug rehab centers

AmeriHealth insurance plan types

The bottom line

What Is AmeriHealth?

AmeriHealth insurance, which began operations in 1983, has developed into one of the most successful companies of its kind in the United States. The entity formed as a single hospital in West Philadelphia but has grown to become one of the largest Medicaid-managed care groups in the United States. Over five million people in over twelve states and the District of Columbia are now receiving services from AmeriHealth.

HMO plans, individual and family PPO, AmeriHealth Medicare, and Medicaid are some of the most common plans.

What Kind of Medical Services Does AmeriHealth Cover?

The Different Types of Drug Rehab Treatments AmeriHealth Covers

Once you enroll in rehab, your medical provider helps you create a personalized treatment plan. This plan may consist of different treatment programs with additional costs. AmeriHealth rehab insurance may cover some or all of the below treatment programs:

Inpatient treatment program: residential treatment programs are intense, crucial, and highly regulated addiction treatments. They range between 30 days to one year and may take as long as necessary. Counseling involves therapy sessions, medication-assisted treatments, and 24/7 medical supervision.

Partial hospitalization program (PHP): partial hospitalization treatments take place during the day while you spend the nights at home. They are as intense as inpatient programs and ideal for individuals with responsibilities like work or family.

Intensive outpatient program (IOP): you may attend an IOP once done with any of the above programs. Therapy sessions in IOPs last for several hours a day, a few days weekly.

Outpatient treatment and therapy: standard outpatient programs and therapies are ideal for individuals looking to transition to the outside world. They are mostly tailored to help you learn techniques that prevent drug relapse.

Medical detox: detox programs allow you to start addiction recovery safely. You receive intense medical care and medications to reduce withdrawal symptoms. AmeriHealth will cover the entire detox costs for the whole duration, depending on your type of policy and length of stay.

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AmeriHealth Out-of-Pocket Costs

The AmeriHealth insurance coverage you take varies between policies based on different tier levels. These policies and tiers affect the out-of-pocket costs you will incur. Other factors affecting out-of-pocket expenses include the length of drug abuse, the type of substances you used, and how much you used.

Some out-of-pocket costs include copays and deductibles: a deductible is an amount you pay before AmeriHealth insurance can finance your addiction treatment. On the other hand, a copay or coinsurance is an amount you pay every time you seek treatment or health care. You will pay coinsurance after you pay your deductibles.

However, it would help if you were prepared to pay certain costs out of pocket. These costs can be affected by several different factors. It's probable that the length of time you've been using drugs, the total amount you've ingested, and the kind of drugs you've used all play a role.

Get in touch with a mental health professional for advice on insurance coverage for rehab and which treatment plan will best suit your needs. Mainly, a case management specialist may be able to help with the creation of a customized treatment plan. This plan could contain several therapy phases, each of which will help you get closer to your recovery goals.

AmeriHealth

AmeriHealth covers many addiction treatment services.

Rolling Hills Recovery Center accepts a variety of AmeiHealth insurance coverage.

Medically Reviewed:

Dr. Carl Williams Ph.D., LCADC

Rolling Hills Recovery Center

Expert Contributor

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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How Long Does AmeriHealth Cover Drug and Alcohol Addiction Treatments?

The length of rehab depends entirely on your specific needs and addiction because everyone has a different recovery. For instance, an individual who has already gone through detox and inpatient rehab is left with after-care services compared to someone who is just starting rehab. Hence, they take less time in rehab affecting the amount of insurance paid.

Whatever plan you choose, AmeriHealth will specifically personalize it for your specific needs. However, professional recovery experts recommend 90 days in rehab for people starting with recovery. Please remember to verify if the AmeriHealth insurance will cover the treatment program of your choice.

AmeriHealth insurance has these main tiers:

Bronze (least expensive, lowest coverage)
Silver
Gold
Catastrophic (most expensive, highest coverage)

On average, most insurance plans cover costs up to 90 days in rehab. Most importantly, choose the program that will benefit you. If the plan doesn't cover the necessary level of care, try considering outpatient programs because their costs are considerably lower.

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AmeriHealth Out-of-Network Vs. In-Network Alcohol & Drug Rehab Centers

When picking a rehab facility, ensure that they are in-network with AmeriHealth insurance to help keep a lid on your out-of-pocket costs. In-Network means that these facilities work with the insurance policy to offer the best plans, prices, and seamless services in a negotiated contract. In-Network facilities will cover some or most of the rehab costs.

You may incur the added costs if you choose an out-of-network facility with AmeriHealth. Call the rehab center in advance and confirm if it's in-network with AmeriHealth.

Why Recover With RHRC?

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Rolling Hills Recovery Center works with a variety of healthcare providers.

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AmeriHealth Insurance Plan Types

AmeriHealth has a variety of insurance plans to cover different client needs. They include:

Health Maintenance Organization (HMO): HMOs are a network of doctors and other low-cost medical providers who agree to provide services at a specific rate. Your primary care physician (PCP) manages your care and refers you to the appropriate doctor within the network.

HMO (Plus): the HMO plus is an added allowance to the HMO. Here, you can seek a specialist of your choice without any referral. However, the specialist must stay within the AmeriHealth network.

Point-of-Service (POS): a POS contains a primary care physician is coordinating care. You may seek services anywhere, even when it is out-of-network with AmeriHealth.

POS (Plus): while POS plans entail all services included in the POS plan plus, you don't need any referrals for services.

PPO: PPO offers a comprehensive list of specialists and doctors. You don't need referrals here, either.

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The Bottom Line

Treating mental health and substance abuse disorders require time, a strong support network, and a seamless stay at the rehab center. Treatment expenses may be costly and disturb your recovery journey; hence, ensure that you get appropriate insurance coverage. Luckily, AmeriHealth insurance plans cover most or some addiction treatment costs and offer various plans and in-network options.